Sleep Restriction: Up Close and Personal

Some insomnia sufferers who visit my website head straight for the posts on sleep restriction. So I decided to create a video trailer where I could talk about my own experience of sleep restriction: how off-putting the idea was at first, and the results I later achieved.

Some insomnia sufferers who visit my website head straight for the posts on sleep restriction. So I decided to create a video trailer where I could talk about my own experience of sleep restriction: how off-putting the idea was at first, and the results I later achieved.

I posted the video on Facebook last week and got an interesting comment from a friend (who does not have insomnia himself). To him, the idea of restricting sleep time, and then increasing it bit by bit, did not sound counterintuitive at all. He compared it to the building of strength and dexterity that occurs with physical training, and the development of musical ability that occurs with daily practice on an instrument. The idea of improving sleep through the disciplined restriction of time in bed sounded perfectly reasonable to him.

There’s logic in what he says. Yet to those of us with insomnia, sleep restriction can sound daunting and downright scary. We know what it’s like to struggle with the daytime symptoms of insomnia: the fatigue, mood swings, and days when we can’t put two and two together or remember names. Why choose to subject ourselves to a treatment that involves slogging through a period when our symptoms may get worse?

Yet my own experience—and the experience of other insomniacs I went through group therapy with—suggests the bad days are numbered. By the second week we were already noticing improvements in our sleep and daytime stamina. Some of us found relief even sooner. Watch the video and see if you’re convinced.

As usual, I’d love to hear your comments.

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Author: Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.
View all posts by Lois Maharg, The Savvy Insomniac

192 thoughts on “Sleep Restriction: Up Close and Personal”

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Your comments on here have been very encouraging. I am trying to get over a short time but sleeping well. It all started around Christmas, when we were with a lot of people and the time change was different. Since then I have missed 9 full night’s of sleep. The pattern my body was getting used to was sleeping none one night and 10-11 the next night. I would very anxious the night after I slept really well. I read about Sleep Restriction a few days ago and have successfully been sleeping 6 hours for 3 nights. I am wondering if I can increase that tonight or if I should wait a week before increasing? I am very excited that this is working but don’t want to rush into sleeping more too fast and relapse.

If your sleep efficiency is 90% or better, only then do you add 15 minutes to your time in bed, and this becomes your sleep window during the following week. You progress very slowly in this treatment. But if you’re able to follow all the rules, I think you’ll be happy with the results.

I had great success with sleep restriction on my first attempt.
Unfortunately I got a little cocky and thought that I have recovered! I started going to bed early and sleeping in the next morning! Now I have rebound insomnia! Is it alright to restart the sleep restriction process all over again this time? I’m really scared that it wont work this time.

Yes, it’s a good idea to start sleep restriction again. This time, when you discover what your ideal sleep window is, stick to it. Avoid going to bed early and avoid sleeping in. I think you’ll be happy with the result.

The best news is that if sleep restriction worked for you before, you can be confident that it will work again. Good luck with it!

You’re welcome, Yummy. The situation you describe—nodding off over a book and then feeling awake once your head hits the pillow—is one I experienced as I was going through sleep restriction. I’ve written about in chapter 8 in my book, The Savvy Insomniac.

My guess is that there’s some anxiety involved and a learned association between your bed and wakefulness. You’ve developed the expectation that when you go to bed you’ll have trouble sleeping, and so you do. I went through three nights of that before I was finally so sleepy at bedtime that I couldn’t stay awake.

My advice would be to stay the course. Eventually you WILL sleep, and if you stick fast to your bed and rise times, you’ll gradually reprogram your brain to expect—at bedtime—to fall asleep.

Thank you so much Lois. I really hate this insomnia so much that sometimes it made me cry. I really hate the feeling of loneliness in the room when everyone is asleep. I was depressed, low mood etc. I thought I was going to die until I read about sleep restriction on your blog. My 1st attempt worked really well that I thought I recovered and so I started to sleep early and waking up late. I was on the bed using my phone to read on facebook, forums before sleeping etc. (bad habits). I didnt know insomnia would come back to find me so quickly and now I am back to square one.

Really thank you for taking the time to hear me out. Friends and families I spoke to just don’t understand our feelings.

I really hope SRT will work out for me this time again just like the first time.

There’s nothing abnormal about the experience you’re describing. Even though with sleep restriction you may have reprogrammed your brain to expect to sleep when you go to bed rather than lie awake, occasionally something may happen that causes you to slip back into the old pattern and the old ways of thinking and feeling again.

If you go through sleep restriction with a therapist, that person will probably give you a set of instructions for what to do if you start to experience insomnia again. Guess what? Those instructions are pretty similar to the ones you followed during sleep restriction. Get up at the same time every day, and don’t go to bed until you’re sleepy. If that doesn’t work, restrict your normal time in bed by one hour, going to bed and getting up at the same time every day.

Now, on the fairly rare occasions when my sleep goes off track (it usually happens at times when I’m feeling really stressed out), it takes only one or two days of restricting my sleep to get my sleep back on track. If sleep restriction worked for you before, you can be sure that it will continue to work when you need it.

Use of magnesium to relieve anxiety is not something I’ve looked into, but a little bit of research suggests that it might help.

Getting rid of negative thoughts about sleep can be a challenge. You could try an intervention similar to the one used in cognitive behavioral therapy for insomnia. Here’s the URL for a blog post I wrote about that:

and type “anxiety” into the site search box on the right side and at the top of the page. You’ll be able to access various posts I’ve written on different ways of managing anxiety, including mindfulness meditation, yoga, and supplements.

Good luck in moving forward. Now that your sleep has improved, you’re halfway there to where you want to be.

I slept 4 hours the 1st night and struggled to keep myself awake all day. I mean a constant struggle the entire day. The 2nd night (now) I am exhausted but can’t sleep. At this rate I will get zero sleep and there is no way I will be able to force myself awake all day again. Not only that, my head feels like exploding, my stomach is killing me (don’t have stomach problems), and I am having chest pain. I do believe this therapy is dangerous for me.

It sounds like you’re not having an easy time of it. I, too, struggled with a lot of anxiety during the first few nights and felt pretty wasted during the daytime. Yet by the 4th night, I was so sleepy I couldn’t stay awake. That was the turning point for me. I document my experience and that of other insomniacs going through sleep restriction in Chapter 8 of my book, The Savvy Insomniac.

You don’t mention you’re seeing a doctor or a sleep therapist. My suggestion would be to get some help from a professional, someone trained in behavioral sleep medicine or an MD who specializes in treating sleep disorders. There’s absolutely no research out there suggesting that cognitive behavioral therapy for insomnia (CBT-I), which usually involves sleep restriction, is dangerous.

But if you’re feeling like you’re doing something dangerous, my advice would be to stop and get the advice and support of a sleep professional.

I started SR two days ago. The first night I have slept only 2 hours. I was so worried about how many hours I have left to sleep. Yesterday I took sleep medication. Tonight I am back on track. Will my sleep improve if I continue with this therapy ? My insomnia started 1 month ago due to anxiety. I am trying to quit all medications but it is hard. I have a few pills left. Any advice ?

Most people who go through sleep restriction therapy find that it improves their sleep. I know I did, and most of the people who later went through cognitive behavioral therapy (CBT) with me (CBT for insomnia includes sleep restriction) also improved their sleep. The key to success is to follow all the rules.

Sleep restriction (or CBT) is typically prescribed for people whose insomnia is chronic, meaning the problem occurs at least 3 nights a week and has lasted for at least 3 months. In cases of acute insomnia—often tied to stressful situations such as losing a job or a divorce or something else that causes a lot of anxiety—doctors will often prescribe sleeping pills. If the stressful situation is likely to abate, the presumption is that when it does, the person will return to sleeping normally without medication.

If whatever caused your anxiety is not likely to disappear from your life very quickly, then going through sleep restriction, together with developing a strategy to manage the anxiety, might make sense. If I were you I’d check into approaches to managing the anxiety right away. The thing that works best for me is vigorous daily exercise late in the afternoon or early in the evening. Other people have more success with mind–body therapies such as yoga or mindfulness meditation.

As for sleep restriction, it has helped lots and lots of people consolidate and regularize their sleep. But if you’re going to do it, you need to trust in the process and make a point of observing the protocol to the letter. (Maybe you’re already working with a therapist or already know these things.) The process begins with keeping a sleep diary for a week to determine exactly how much to restrict your sleep during the first week of therapy. You continue to maintain the sleep diary throughout the sleep restriction process. At the end of each week, you calculate your sleep efficiency to determine how much to restrict your sleep the following week. And so on, until you reach the point where you’re sleeping as much as you can while still maintaining a high sleep efficiency.

I’ve made lots of blog posts about sleep restriction therapy. If you haven’t already read much about it, I think you’ll find some of these posts to be helpful:

When you’re going through sleep restriction therapy, it is normal to experience some sleep loss during the first few weeks of treatment. And it’s normal to feel a bit “off” during the daytime. Also, coming off sleeping pills, some people experience a brief adjustment period where they’re not sleeping as soundly as they’d like.

But if you continue the sleep restriction treatment (you mention working with a therapist, which is good) you can expect that your sleep will start improving fairly soon. I can’t give you an exact date because all of us are different in that regard. I started seeing improvements in my sleep on the fourth night of treatment. Another person I know started seeing improvements in the second week of treatment. Others started seeing improved sleep in the third week of treatment.

The important thing here is to trust that the treatment will very likely help you and do your level best to observe all the rules. If you missed my response to your earlier query, take a look at what I wrote above. Again, best of luck.

I’m on my third night of the sleep protocol. Last night was particularly difficult. I kept nodding off the last few hours before my allotted sleep time (mine is a slot between 2:30 & 6:30am). My sleep has been very spotty since beginning, waking every half hour or more. That was on Benzos. I haven’t slept the 4 hours yet on this protocol.. I feel utterly exhausted, but when it’s time to get into bed, I lie there awake! Is that normal?

I have been dealing with insomnia for the past two years, the past year has been particularly rough with an average of 3-5 hours (5 on a good night). I see a therapist and do yoga regularity. A stressful family event that finally played out started my anxiety, depression, physical ailments (such as stomach issues) and insomnia. I’m dealing with the anxiety and physical issues separately.

I also use a 10k lux lightbox upon waking for 20-30 minutes.

Thankfully, I’m not working outside of the home at this time so I’m able to relax when I feel I can’t stand it (but not napping).

I’m hoping I can persevere & cope with the crashed feelings during the day and my body starts to respond to the therapy soon. Those hours waiting to retire are so lonely and I feel afraid I’m harming myself even further.

I’m sorry to hear that stress and insomnia are giving you such a rough ride these days. But it’s good you’re getting help with the anxiety, depression, and physical health issues. Yoga should be quite helpful. And sleep restriction may well help you improve your sleep.

You say that although you feel exhausted, when it’s time to go to bed you’re wide awake. This is a common experience—I hear about it all the time. It was my experience too (and I document what it felt like to me in chapter 8 of my book). It suggests that some of the anxiety you’re experiencing these days is anxiety about sleep itself—about not getting enough, about your crashed feelings during the daytime, and about the harm this might be inflicting on your body.

Cognitive behavioral therapy for insomnia—which includes sleep restriction therapy—has a cognitive component that might also help you manage your sleep anxiety so that it wouldn’t interfere so much with your sleep. A behavioral sleep therapist would be able to coach you on this. Here’s another blog post that lays out what the cognitive component of CBT entails: https://thesavvyinsomniac.com/2014/03/31/ease-insomnia-by-changing-negative-thoughts/

Here’s another thought, and I apologize if I’m making an assumption I should not make. You say you’re not working outside your home and that you feel lonely in the hours leading up to bedtime. While it’s not a good idea to go through sleep restriction when you’re having to be in super high performance mode, neither is it a good idea to have too much time on your hands. I’m wondering if during the daytime it would be a good idea to get out and about a bit more or to take on a few more projects? It might help to focus your mind on other things and give yourself a break from thinking about sleep and sleeplessness.

Maybe you’re already working with a behavioral sleep therapist. If so, follow the protocol that your therapist lays out. That said, I rarely hear of therapists who advise beginning sleep restriction with a 4-hour sleep window. One I know says it’s OK to begin with a 4.5-hour window. Several others advise starting with nothing less than a 5-hour window. You don’t want to become too sleep deprived during this process.

So many people I hear from during sleep restriction have a problem with nodding off before their specified bedtime. I did, too! I think the best way to keep yourself aroused in the run-up to bedtime is to think of a list of quiet activities you could be doing in the run-up to bedtime—activities that involve a bit of movement and that are not disagreeable. Working on a jigsaw puzzle, for example, or on a craft. Sorting old family photos into albums or even playing Solitaire. Sitting passively in front of the TV is the worst kind of thing to do—you’re sure to nod off too soon.

Anyway, if you stick with the sleep restriction protocol, you’ll likely start seeing good results by the second or third week and maybe even sooner.

I have tried SRT for sleep maintenance insomnia. Had it for maybe 10 years…I usuall go to sleep at like 10am, fall asleep in 20 mins..wake up about 4 hours later and am up til like 5am, then pass out for another hour…NO MATTER WHATTT EVERY SINGLE SOLITARY NIGHT! NEVER A BREAK EVER! SRT worked a little bit in that it did consolidate my sleep into a 5 hour block instead of 4…but over time it gradually went back to 4 hours…What do you suggest? I have no other medical reasons for insomnia and have been to tons of doctors…tell me your thoughts and opinion…Doesnt seem like ANYBODY truly has seen SRT thru from these message boards and other websites, just people who say Oh i wanna give it a shot…but it seems just SO difficult that virtually nobody finishes this…I do feel like even if I did keep it up for a year or more, it would still ultimately go back to the 4 hour of broken up sleep once the sleep drive is decreased…

You’ve put your finger on the main goal of sleep restriction therapy (SRT): helping people with insomnia (1) build up enough sleep pressure to readily fall asleep and stay asleep at night, and (2) maintain enough sleep pressure to continue falling and staying asleep through the night. It is not a cure for insomnia in the sense that once you’ve gone through 4 weeks of therapy you can revert to your old habits and expect to continue having consolidated sleep. If you revert to your old habits, your sleep will likely return to the way it was before. But if as a result of SRT you establish new sleep habits, then your consolidated sleep should continue and may even continue to improve.

Although my problem was sleep onset insomnia, I’ll used myself as an example. Before doing SRT, I had two habits that did a lot to keep my insomnia going. I (1) went to bed at the first sign of sleepiness, and (2) allowed myself to sleep in when I could. During SRT, I had to give those up, staying out of bed till later than I was used to and observing a fixed rise time. Doing both these things made it so much easier to fall and stay asleep and of course I wanted that to continue.

Now at night I set my alarm clock for 6 a.m. and get up when it rings. At night, instead of heading to bed at the first sign of sleepiness, I keep trying and trying to read a book. Finally when it’s clear that I’m too sleepy to keep my eyes open, I head to bed. I don’t look at clocks; I don’t truly know exactly how much sleep I’m getting these days. But I do know this: I fall asleep soon after my head hits the pillow, usually sleep through the night, and rarely suffer the kinds of daytime impairments I used to experience after my many nights of insomnia.

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